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      The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists

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          Abstract

          Buddhist-derived meditation practices are currently being employed as a popular form of health promotion. While meditation programs draw inspiration from Buddhist textual sources for the benefits of meditation, these sources also acknowledge a wide range of other effects beyond health-related outcomes. The Varieties of Contemplative Experience study investigates meditation-related experiences that are typically underreported, particularly experiences that are described as challenging, difficult, distressing, functionally impairing, and/or requiring additional support. A mixed-methods approach featured qualitative interviews with Western Buddhist meditation practitioners and experts in Theravāda, Zen, and Tibetan traditions. Interview questions probed meditation experiences and influencing factors, including interpretations and management strategies. A follow-up survey provided quantitative assessments of causality, impairment and other demographic and practice-related variables. The content-driven thematic analysis of interviews yielded a taxonomy of 59 meditation-related experiences across 7 domains: cognitive, perceptual, affective, somatic, conative, sense of self, and social. Even in cases where the phenomenology was similar across participants, interpretations of and responses to the experiences differed considerably. The associated valence ranged from very positive to very negative, and the associated level of distress and functional impairment ranged from minimal and transient to severe and enduring. In order to determine what factors may influence the valence, impact, and response to any given experience, the study also identified 26 categories of influencing factors across 4 domains: practitioner-level factors, practice-level factors, relationships, and health behaviors. By identifying a broader range of experiences associated with meditation, along with the factors that contribute to the presence and management of experiences reported as challenging, difficult, distressing or functionally impairing, this study aims to increase our understanding of the effects of contemplative practices and to provide resources for mediators, clinicians, meditation researchers, and meditation teachers.

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          Basics of Qualitative Research : Techniques and Procedures for Developing Grounded Theory

          The Second Edition of this best-selling textbook continues to offer immensely practical advice and technical expertise that will aid researchers in analyzing and interpreting their collected data, and ultimately build theory from it. The authors provide a step-by-step guide to the research act. Full of definitions and illustrative examples, the book presents criteria for evaluating a study as well as responses to common questions posed by students of qualitative research.
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            Attention regulation and monitoring in meditation.

            Meditation can be conceptualized as a family of complex emotional and attentional regulatory training regimes developed for various ends, including the cultivation of well-being and emotional balance. Among these various practices, there are two styles that are commonly studied. One style, focused attention meditation, entails the voluntary focusing of attention on a chosen object. The other style, open monitoring meditation, involves nonreactive monitoring of the content of experience from moment to moment. The potential regulatory functions of these practices on attention and emotion processes could have a long-term impact on the brain and behavior.
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              Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.

              This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social phobia, and simple phobia. More than half of all lifetime disorders occurred in the 14% of the population who had a history of three or more comorbid disorders. These highly comorbid people also included the vast majority of people with severe disorders. Less than 40% of those with a lifetime disorder had ever received professional treatment, and less than 20% of those with a recent disorder had been in treatment during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders. This suggests that the causes and consequences of high comorbidity should be the focus of research attention. The majority of people with psychiatric disorders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion who ever obtain specialty sector mental health treatment is less than 50%. These results argue for the importance of more outreach and more research on barriers to professional help-seeking.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                24 May 2017
                2017
                : 12
                : 5
                : e0176239
                Affiliations
                [1 ]Cogut Center for the Humanities, Brown University, Providence, Rhode Island, United States of America
                [2 ]Department of Religious Studies, University of California, Santa Barbara, California, United States of America
                [3 ]Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, Rhode Island, United States of America
                [4 ]Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
                Virginia Commonwealth University, UNITED STATES
                Author notes

                Competing Interests: The Bial Foundation is a commercial source that provided funding for this research. The funder had no role in the study design; collection, analysis, and interpretation of data; writing of the paper; and/or decision to submit for publication. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                • Conceptualization: WB JL.

                • Data curation: JL DC NF.

                • Formal analysis: JL DC NF.

                • Funding acquisition: WB NF JL.

                • Investigation: WB JL NF DC.

                • Methodology: WB JL RR.

                • Writing – original draft: WB JL DC NF RR.

                • Writing – review & editing: WB JL DC NF RR.

                [¤]

                Current address: Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, Rhode Island, United States of America

                ‡ These authors also contributed equally to this work.

                Author information
                http://orcid.org/0000-0002-2983-0863
                Article
                PONE-D-16-30967
                10.1371/journal.pone.0176239
                5443484
                28542181
                a0c36ac4-848c-40b3-9585-abc4104d3698
                © 2017 Lindahl et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 2 August 2016
                : 2 April 2017
                Page count
                Figures: 1, Tables: 6, Pages: 38
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100000064, National Center for Complementary and Alternative Medicine;
                Award ID: K23-AT006328-01A1
                Award Recipient :
                Funded by: Mind and Life Institute
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100005032, Fundação Bial;
                Award ID: 256/12
                Award Recipient :
                Funded by: 1440 Foundation
                Award Recipient :
                This study was supported by grant number K23-AT006328-01A1 from the National Center for Complementary and Integrative Health ( https://nccih.nih.gov/) at the National Institutes of Health, grant number 256/12 from the Bial Foundation ( www.bial.com) (WB), the Varela Research Award from the Mind and Life Institute ( www.mindandlife.org) (NF) and the 1440 Foundation ( www.1440.org) (WB, JL). The funders had no role in the study design, data collection, decision to publish or preparation of the manuscript.
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                All relevant data are within the paper and its Supporting Information files. Sensitive and potentially identifying information, including original interviews, cannot be provided due to ethical restrictions. Requests may be sent to the Brown University Institutional Review Board ( IRB@ 123456Brown.edu ).

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